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If those who are self-medicating are taught that they put their own health at risk, they may be less likely to use these online pharmacies. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. For example, we found that servers at Dartmouth College, East Carolina University, University of Pittsburgh, Carnegie Mellon University, and California State University in San Francisco were all used, most likely without their knowledge, to be reassigned to online pharmacies. Clinicians evaluating the patient's use of self-medication when taking a medical history may function as an important opportunity to tell patients about not only antibiotic resistance, but also potential interactions between antibiotics and other prescription drugs. Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection. In conclusion, antibiotics are freely available for purchase over the Internet without a prescription, and the general structure of transactions encourages self-medication and poor quality care. Fifth, we estimated the expected delivery time to take antibiotics. We classified Web sites of vendors according to several variables. Our study is the first to document this phenomenon, and we describe the mechanism for purchasing antibiotics online; future studies will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance. In addition, the ability of Internet-based companies to exist without an identifiable physical location or property makes the location and writing of FDA instructions extremely difficult. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. Fourth, we have limited our count to English language websites. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. Thus, vendors targeting foreign-language speakers in the United States would have been missed.